What is Pelvic Floor Pain?
Pelvic floor pain is a condition characterized by pain in the pelvic area due to weakness, spasm, or injury to the pelvic floor muscles, causing dysfunction.
The pelvic floor consists of a group of muscles and ligaments that provide support to the lower abdomen, bladder, vagina, uterus, and rectum in the pelvic region, and helps in the functioning of these organs. It helps control the urinary bladder, sexual activity, and bowel movements. Pelvic floor dysfunction can cause pain and disrupt these crucial functions.
Causes of Pelvic Floor Pain
Most causes of pelvic floor dysfunction and pain are still unclear; however, certain events or conditions have been associated with pelvic muscle weakness, such as:
- Trauma or injury to the pelvic region
- Pelvic surgery
- Childbirth
- Obesity
- Radiation treatment
- Heavy lifting
- Nerve damage
Symptoms Associated with Pelvic Floor Pain
There are several symptoms associated with pelvic floor pain; some of the most common include:
- Vaginal bleeding
- Pelvic floor weakness
- Painful urination
- Hyperactivity of pelvic muscles
- Pelvic tenderness
- Lower back pain
- Nausea
- Abdominal cramps
- Pain during intercourse
Diagnosis of Pelvic Floor Pain
Your doctor will review your medical history and symptoms and perform a physical examination as needed to assess your pain, performing certain tests to evaluate the pelvic floor for weakness, lack of control, muscle spasms, or knots. A rectal or vaginal examination may be performed with a gloved finger (digital examination) or a sensing device. Other tests include:
- Transabdominal ultrasound: A non-invasive technique in which ultrasound waves are passed through a transducer placed on the abdomen that produces images of the internal organs
- Endorectal ultrasound in which a lubricated ultrasound probe is introduced into the anus to obtain images of the pelvic structures, such as control muscles, anus, and rectal wall
- Anorectal manometry to evaluate the functionality of control muscles and rectum and strength of these muscles
- Electromyography (EMG) to evaluate the functionality of several nerves in the anal sphincter and pelvic floor
- Videodefecogram, a special x-ray that is taken during a bowel movement to check muscle movement and is a crucial test to determine pelvic floor dysfunction
- Colonic transit study, a series of x-rays that evaluates the passage of stool through the colon to detect potential locations and causes of constipation
Your doctor may also perform tests to rule out other causes of pelvic pain.
Treatment for Pelvic Floor Pain
Treatment for pelvic floor dysfunction and pain includes:
- Medication: Your physician may prescribe a muscle relaxant to deal with pelvic floor dysfunction. The relaxant prevents the contraction of pelvic muscles and helps in destressing the muscles.
- Biofeedback: In this method, your doctor will use special sensors and video to monitor the pelvic floor muscles as you relax or contract them. After observing the muscle activity, your doctor will provide feedback to improve the coordination.
- Physical Therapy: Your doctor may recommend physical therapy to strengthen the pelvic muscles.
- Trigger Point Injections: This injection contains corticosteroids that are introduced to treat muscle spasms causing pain.
- Relaxation techniques: Your doctor will recommend relaxation techniques such as yoga and stretching to relax your pelvic floor muscles.
- Surgery: Your doctor will recommend surgery in the case of organ prolapse.
